A Republican Senate Health Care Bill So Bad, It’s Called BCRAP

You can’t make this stuff up folks. The Senate version of repealing and replacing the Affordable Care Act is being called the “Better Care Reconciliation Act” Plan (BCRAP).

Passage of the legislation means more than 20 million (final number TBD next week) will lose healthcare coverage, premiums will skyrocket, especially for older Americans, as the lack of a mandate will remove incentives for healthy people to enroll.

It will be crappy for the 1.8 million people out of a job by 2022. By capping payments to Medicaid, states will be forced to choose between slashing funding for services across the board or paying for healthcare.

Medicaid covers 62 million Americans—almost as many as Medicare and the entire individual market combined. The New York Timesrecently noted it insures about half of all births and 40% of children.

Those benefits currently described as essential, including mental illness, maternity and, hospitalization coverage will be eliminated as that part of the law is ‘sunsetted’ on December 31, 2019.

SUNSET OF ESSENTIAL HEALTH BENEFITS REQUIREMENT. — Section 1937(b)(5) of the Social Security Act (42 U.S.C. 1396u–7(b)(5)) is amended by adding at the end the following: “This paragraph shall not apply after December 31, 2019.”. [Better Care Reconciliation Act of 2017]

It should surprise no one that Senate Republicans found a loophole allowing them to (temporarily) eliminate funding for Planned Parenthood. Yet another victory for the fundamentalist Christian theocratic agenda.

Here’s how Larry Levitt, a senior vice president at the Kaiser Family Foundation, explained the whole thing to me this morning:

The House bill cuts about a trillion dollars in federal spending on health care for poor people, in exchange for substantial tax cuts, primarily for the wealthy. If the tax cuts remain in the Senate bill, then all they can do is rearrange the cuts in federal health spending on low income people. But their overall magnitude has to be the same.

On Medicaid, the Senate bill’s phase-out of the expansion would appear to be slower, in exchange for a more stringent formula for cuts over time. The Senate bill would get to the same or potentially even deeper Medicaid reductions as the House bill would over time. On the subsidies, there is a redistribution, but it’s fundamentally still a significant reduction in help for low income people. They cut off subsidies for higher income people, in exchange for an increase in subsidies for lower income people — relative to the House bill. But overall, health care would still be much less affordable for low income people than it is currently under the ACA.

Moderate Republican senators, however, will be able to employ some kind of clever talking point about the fact that the Medicaid expansion phaseout will be slower. Look for a lot of recitations of the phrases “slower glide path” and “softer landing.” And Trump will say the bill is no longer “mean.” But at bottom, it’s all basically a cruel, cynical shell game.

For an overview of how BCRAP will play out over the coming week, here are Ezra Levin and Leah Greenberg, Co-Executive Directors of Indivisible, via Daily Kos:

Senate Republicans have promised a vote by the end of next week. But there are still several steps between now and passage of TrumpCare. Here’s how the former congressional staff at Indivisible think the fight will unfurl:

Tomorrow, we’ll get a Congressional Budget Office (CBO) score, which will quantify exactly how many millions of Americans will be screwed by this bill and in what ways

On Monday or Tuesday, Republicans will officially announce the vote is happening by the end of the week and start debate on “the bill,” which is a fake bill intended to make it look like they’re being transparent but in reality is a trick to hide just how awful their finished product will be

Over the next couple days, Senators will submit amendments* (See below)

On Thursday, the Senate will plan to vote on the legislation, but first they will vote on all submitted amendments (known as “vote-a-rama”)

At the last possible minute, Senate Republicans will replace the entire bill they just got finished “debating” with an alternative TrumpCare bill secretly crafted behind closed doors

By end of Thursday, there will be a final vote in the Senate

As soon as Friday, the House may then pass the legislation and send it to Trump to sign. This could take longer, but this is the worst case scenario and quite possible.

On Friday, one week of congressional recess begins. They’ll either have the bill done by Friday, or they’ll have to wait another week.

Throughout this process there will be precisely zero public hearings in the Senate. Make no mistake, this is a historically partisan, secretive, and undemocratic process for one of the largest pieces of legislation of our generation. This is atrocious.

Make no mistake about it, this coming week represents the best opportunity for Republicans to enact their bill. Regardless of what form it takes when the vote comes in the Senate, their intentions are clear: cut coverage and give the wealthy a tax cut.

A massive response is what’s needed. Republican legislators must be persuaded that the political cost of supporting BCRAP isn’t worth the benefits party leaders are promising.

Over the next week, there will be sit-ins and protests at key congressional offices around the country. (Mostly in states with GOP Senators, but check here for the latest additions)

Gum up the works.* Senators can submit as many amendments as they want. Every amendment takes time to be introduced and voted on. Indivisible is collecting amendments and submitting them directly to Senate staff. Click here to submit your amendment.

This tool kit that will aid you in calling, faxing or leaving a voice message for your senator, and help you quickly determine whether any of your friends live in key states, so you can reach out accordingly.

If you’re not sure what to say when you call, you can use a call script written by one of the grassroots advocacy groups organizing against this bill. The Indivisible Project is currently offering call scripts for people living in key states, and for people who live elsewhere.

If your senator is a Democrat, hit them up anyway and demand that they use every tactic at their disposal to stop this bill. There are call scripts available for these conversations as well, if you need them.

Deploy your efforts strategically. Don’t, for example, jam the phone lines of other people’s senators. They will only be swayed by the people who can vote them out, so mobilizing those people to call is the best way to impact those districts.

This is one of those moments when we have to prove that we are who we say we are. Win, lose or draw, let’s not lose sight of that. And don’t forget the power of direct action.

There’s nothing more frightening to a politician than entire movements aiming to bring them down. We can flex that power because it’s always with us. When rage meets creativity, we can move the earth. So, let’s remind those who would kill us that we won’t go out without a fight.

Note: Yes, I know that Medicare for All or some variant on Single Payer is what we really need in this country. But that’s not what’s being considered this week.

Looking for some action?Check out the Weekly Progressive Calendar, published every Friday in this space, featuring Demonstrations, Rallies, Teach-ins, Meet Ups and other opportunities to get your activism on.

I read the Daily Fishwrap(s) so you don’t have to… Catch “the Starting Line” Monday thru Friday right here at San Diego Free Press (dot) org. Send your hate mail and ideas to DougPorter@SanDiegoFreePress.Org Check us out on Facebook and Twitter.

Doug Porter

Doug Porter was active in the early days of the alternative press in San Diego, contributing to the OB Liberator, the print version of the OB Rag, the San Diego Door, and the San Diego Street Journal. He went on to have a 35-year career in the Hospitality business and decided to go back into raising hell when he retired. He won numerous awards for his columns from the Society of Professional Journalists in 2012, 2013, 2014, 2015, 2016 and 2017. Doug is a cancer survivor (sans vocal chords) and lives in North Park.